Individual
DIANA ILYAYEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(347) 592-3745
Mailing address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(347) 592-3745
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/17/2021
Last updated
02/08/2021
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